Age, Ethnicity, and Drug Use Increase Risk of Chronic HCV Infection

Since first being identified in 1989, hepatitis C virus (HCV) has quickly gained attention as a public health concern due to its intense proliferation and negative consequences associated with chronic infection. HCV infections are now more common than HIV/AIDS infections and, unlike hepatitis B virus, HCV lack available vaccines.

Because injection drug use is by far the most significant risk factor for contracting HCV, and continued substance use among those infected with HCV raises their risk for developing complications, as well as spreading the infection, this study from the National Drug Abuse Clinical Trials Network (CTN) aimed to better understand the risk factors associated with HCV among patients enrolled into medication-assisted therapy for opioid dependence.

One thousand and thirty-nine patients were randomized as part of a larger CTN study assessing liver function in opioid-dependent participants randomized to either buprenorphine/naloxone or methadone treatment.
Patients were assessed for HCV and then classified into one of three groups:

HCV negative

HCV positive but have cleared the virusm

Chronic HCV infection

Thirty-four percent of patients were classified with chronic infection and 14% had evidence of prior infection with apparent clearing of the virus. Chronic infection was associated with recent injection drug use and cocaine use. It was also associated with being older and Hispanic.

Conclusions: Being a current injection drug user, being older, and being Hispanic were all traits that increased the likelihood that participants were chronically infected with HCV. This information is useful because it can help with the development of strategies targeting these higher risk subgroups to better prevent disease escalation.

Further research would benefit from better understanding of the role of ethnicity in transmission and/or spontaneous remission. Early prevention and continuous monitoring of injection drug users should be the primary focus for addressing this epidemic.

Funding for this Addiction Science Made Easy project is provided by the Addiction Technology Transfer Center National Office, under the cooperative agreement from the Center for Substance Abuse Treatment of SAMHSA.